AccountId: 011433970860
ContactId: 8eccbbcc-2cd9-46dd-9fac-bce733d1d223
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 564960 ms
Total Talk Time (AGENT): 188107 ms
Total Talk Time (CUSTOMER): 244284 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/8eccbbcc-2cd9-46dd-9fac-bce733d1d223_20250414T15:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], I am needing to know my policy number.
[AGENT][NEUTRAL] OK. Do you have your social or your last name?
[CUSTOMER][NEUTRAL] Yes, [PII]. Yes, [PII].
[CUSTOMER][NEUTRAL] And my number is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, it looks like I've got a policy in here, but it looks like it's terminated. Do you, are you, were you aware that it was terminated or are you looking for a
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Let's see what's going on
[CUSTOMER][NEGATIVE] Cause I thought we were paying so much a month for that.
[AGENT][NEUTRAL] Um, let me just verify a few pieces of information if you don't mind. What is your birth date?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] And your address?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Um, it looks like it's, uh, I've got an old, maybe an old address.
[CUSTOMER][NEUTRAL] Do, yes, and see, I called this summer and to update all that.
[CUSTOMER][NEGATIVE] It's not.
[AGENT][NEGATIVE] Yeah, I show it, it terminated back in [PII], and I don't have anything active.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is it under [PII]?
[CUSTOMER][NEUTRAL] And I'm under his policy maybe my husband's [PII].
[AGENT][NEUTRAL] OK, let me look at that. Hold on one moment.
[AGENT][NEUTRAL] Do you by chance have his social?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And Ms. [PII], do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, let's see, sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You show an active policy here. Do you have his birth date?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEGATIVE] Oh no.
[AGENT][NEUTRAL] OK, yes, this one's active. And what was that uh new address? Make sure we have the right thing.
[CUSTOMER][NEUTRAL] [PII], OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, perfect. We've got that. OK, and then what can I help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, on, I'm trying to fill out paperwork, but it's asking.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Have I had this condition before? I was just diagnosed with colon and breast cancer, but I've had it in [PII].
[CUSTOMER][NEUTRAL] So since it's been that long, would this still be covered under this policy?
[AGENT][NEUTRAL] Um, yeah, the pre-existing is typically a 12 month look back period, so that should be fine, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That should be OK. All right. So when it says the primary insured would be Charlie. Is that correct?
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] OK. All right. And then what is the, our policy number?
[AGENT][NEUTRAL] OK, policy number is 255928.
[CUSTOMER][NEUTRAL] 25,599,280
[AGENT][NEUTRAL] 80.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, and so it'll be under Charlie.
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][POSITIVE] OK. All right. That, that is perfect. 2,559,280.
[AGENT][POSITIVE] That's right, yeah.
[CUSTOMER][NEUTRAL] OK. And so, um,
[CUSTOMER][NEUTRAL] I'll just have my doctors write down, like when I'm, do you want the diagnosis or the surgery? So like, what would I, what would I be able to receive with those two diagnosis? Do I just get one or how does that work?
[AGENT][NEUTRAL] Uh, let me pull up your policy and see what we've got here. Um, anything I quote today is not a guarantee of payment. It's a basic outline of your policy.
[CUSTOMER][POSITIVE] OK. I'll do well. Sure, I get it.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] For uh first occurrence, um,
[AGENT][NEUTRAL] But you said this is, is this a reoccurring? So it's not your first occurring? OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] For both.
[AGENT][NEUTRAL] And are you, are you starting the treatment and, or do you have a plan yet or?
[CUSTOMER][NEUTRAL] Well, what I, it, yes, well, I don't, for the colon, they just did surgery, and then I'm going next week for breast cancer and having surgery, so I don't know about treatments yet.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so, radiation, chemo, immunotherapy is, is, is a $15,000 benefit per covered person for 12-month period.
[AGENT][NEUTRAL] And that that's a
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Altogether 15,000. Uh, looks like, let's see, surgical.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, surgical treatment, there's a max of 3000 per operation.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that those would be separate, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then, and then you do have.
[CUSTOMER][NEUTRAL] And then with having a um mastect and I'm sorry, go ahead.
[AGENT][NEUTRAL] Um, there's also a benefit for anesthesia, so they do pay 1% of the covered services of 25%.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and then you said massive.
[CUSTOMER][NEUTRAL] And would that include.
[CUSTOMER][NEUTRAL] Yeah, would, would, on the anesthesia, would that include like when I have the colonoscopies as well, or no? Or is that just surgery?
[AGENT][NEUTRAL] That's just surgery. Yes, correct.
[CUSTOMER][NEUTRAL] OK. All right. So I just, so the dates I need to give you are the dates of my surgery, but I do need to give you the date, like when I had my colonoscopy and I was diagnosed. Is, is that the first date you need?
[AGENT][NEUTRAL] Yes, that is. Um, so if you have like a pathology report, that would suffice. Um, that's typically what we're looking for is a pathology report that shows the actual diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so I will get the pathology reports on those and then um do I need to put dates of when I went? Is there any coverage on mileage or anything like that or?
[AGENT][NEUTRAL] Um, let me see if there's a travel.
[AGENT][NEUTRAL] OK, so yes, there is a travel benefit and it has to be at least 50 miles from your home.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then we're gonna pay 75 cents per mile um for travel.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. All right. And then, is there a time frame of when I have to turn this in or?
[AGENT][NEUTRAL] No, no time frame. Yeah, we don't have any kind of timely filing limit, so you've got as long as you need.
[CUSTOMER][NEUTRAL] OK, so I, let me write down what, what I need to get you. I need pathology.
[CUSTOMER][NEUTRAL] I need travel. So do you need dates of the days I went, each time I went to [PII]?
[AGENT][NEUTRAL] Yes, so we'll need, yeah, we'll need something that shows, you know, the services that were rendered, your diagnosis and the dates that you went, and then the bill charges.
[CUSTOMER][NEUTRAL] To the hospital.
[CUSTOMER][NEUTRAL] OK, and then the bill charges?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. I will try to get all that together. Um, and then just send it to um the [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. All right. Well, that helps a lot. And then on, on one of my papers, I have that there's a 0 in front of the 2,559,280. Do I need to put that 0 there or no?
[AGENT][NEUTRAL] It, yeah, it doesn't matter. We, we can find it either way.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, all right, well thank you so much for your help.
[AGENT][POSITIVE] OK, well, thank you for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Oh, you too. Thank you. Bye-bye.